Benzodiazepine Use in Alzheimer’s Patients Increases Mortality Risk

Joensuu, Finland—The risk of dying increases 40% for Alzheimer’s disease (AD) patients who are prescribed benzodiazepines for symptoms such as anxiety, agitation, and insomnia, a new study warns.

The report in the InternationalJournal of Geriatric Psychiatry determined that the increased risk began with initiation of the drugs. Researchers from the University of Eastern Finland posited that adverse effects from the drug class, such as fall-related injuries, pneumonia, and stroke, could help explain the increased mortality rates.

The register-based MEDALZ (Medication Use and Alzheimer’s Disease) cohort, including all patients diagnosed with AD in Finland during 2005–2011, was used for the study, which ultimately included more than 10,000 new users of benzodiazepine and related medications (BZDR). Those patients were compared with a control group of more than 20,000 nonusers of the drugs who were matched for age, gender, and time since AD diagnosis. The primary outcome was defined as 180-day mortality.

Results indicate that, compared with the control groups, five excess deaths per 100 person-years occurred during BZDR use in comparison with nonuse; mortality rates were 13.4 versus 8.5.

The association between use of the drugs and death, an adjusted hazard ratio of 1.4, began with initiation of use, the researchers pointed out. Further analysis found that benzodiazepine use was associated with an increased risk of death but benzodiazepine-related drug use was not, according to the report.

Study authors noted that treatment guidelines usually call for nonpharmacologic options as the first-line treatment for anxiety, agitation, and insomnia in dementia patients. They added, however, that benzodiazepines and related drugs are frequently used in the treatment of these symptoms. For such cases, the researchers urge only short-term use.

“Our results support treatment guidelines stating that nonpharmacological approaches should be the first-line option for symptomatic treatment of AD,” they emphasize.

A study last year from the University of Eastern Finland demonstrated that the use of benzodiazepines and related drugs increases the risk of hip fracture by 43% in persons with AD. Results of that study were published in the Journal of the American Medical Directors Association.